Government unveils $436m health program

The federal government has announced a $436 million program to encourage diabetes sufferers to sign up with single GP practice for ongoing care, the latest element of its health reform agenda.

Under the program the practice would come up with a “personalised care plan" and coordinate access to other health providers such as dieticians and physiotherapists.

A GP practice would be paid about $1200 annually for each patient enrolled, to cover the costs of day-to-day care and services.

They would also receive around $10,800 a year “paid in part on the basis of performance in providing better care and improving health outcomes", Prime Minister
Kevin Rudd
said. “These reforms mark the beginning of a new way of treating Australians with long-term illness."

The government says about 240,000 hospital admissions each year are due to diabetes complications and they could be avoided by better management.

“This is 32 per cent of all avoidable hospital admissions," Mr Rudd said.

A “detailed implementation policy" is yet to be finalised.

That will be nutted out with key stakeholders, federal Labor says.

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But doctors already are split on the desirability of asking patients to voluntarily enrol with a particular general practice. The Australian General Practice Network says the program will result in fewer diabetes sufferers being hospitalised.

“With every new statistic telling us the population is getting fatter that’s more diabetes cases waiting to happen," network chairman Emil Djakic said. “For those born with the disease, good care can mean a healthier future."

However, the Australian Medical Association slammed the announcement as “policy on the run".

Association president Andrew Pesce said the announcement was a rushed attempt to convince the states and territories to sign up to the federal government’s hospitals overhaul.

“It is clear that linking this announcement to relieving pressure on hospitals is designed to have more of a positive effect on the premiers than on people with diabetes," Dr Pesce said.

The AMA was not consulted on the diabetes program.

“Serious consultation with the medical profession should occur before the policy is developed, not after the event," Dr Pesce said.

By moving away from the standard “fee for service" arrangements the government was removing patient choice and eroding the individual doctor-patient relationship.

“The new arrangements would encourage no-minute medicine as GPs would be forced to refer patients with diabetes to other specialists such as endocrinologists."

But Mr Rudd believes 4300 general practices, covering 60 per cent of all GPs, will get on board by 2012-13 when the program is expected to begin.

“The government expects that approximately 260,000 patients with diabetes will be voluntarily enrolled in a personalised care program by 2013-14," Mr Rudd said.

The government argues that if it funds 60 per cent of public hospital costs and 100 per cent of primary care costs it will have an interest in making sure patients are not bumped from one system to the other.

“The commonwealth will have an interest in ensuring that Australians receive high quality care in the community," Mr Rudd said.

Speaking before Mr Rudd announced a $436 million diabetes program, Opposition Leader Tony Abbott said the fact there was no extra money for hospitals until at least 2014 was a key problem with the PM’s plan.

“My position all along has been that the problem with Mr Rudd’s position is that, at least on what we’ve been told so far, there are no new beds, no new doctors, no new nurses and not even any new dollars until 2014 at least," he said.

“If he can fix the plan, sure, I’m happy to be constructive, but at the moment it’s more of a press release than a plan."

Announcing the policy at the site of a new GP Superclinic at Geelong, Mr Rudd said it was all about keeping people out of hospital, and that under the plan GP clinics would receive bonus payments for keeping diabetes patients out of hospitals.

“We will be providing a performance-based payment to the GP clinic, those responsible for the care of patients suffering from diabetes, based on keeping these fellow Australians of ours out of hospital," Mr Rudd said.

“So we are providing patient-based care, basing that in what’s done through our GP clinics, ensuring our GPs are properly supported for taking on that extra role, and also providing performance-based payments to those clinics to maximise the number of people we keep out of hospital."